What is the background to this study?

Two-thirds of people drive or car-share to work and for people with limited mobility, driving is often key for helping them to stay independent. However, driving can be challenging for people who have musculoskeletal conditions – especially for people with conditions that affect the spine and neck like axial spondyloarthritis (axSpA). Struggling to drive because of a musculoskeletal condition could have a negative impact on a person’s ability to work. 

What did we want to find out?

Firstly, we wanted to better understand the different types of challenges people with axSpA have while driving. Secondly, we wanted to find out what personal and clinical features are associated with these challenges – for example, are people with more active disease more likely to struggle with their driving? Lastly, we wanted to find out whether different driving challenges are linked to difficulties at work – for example, missing days of work because of their axSpA or feeling less productive while at work.

What did we do?

As part of another study, The Scotland Registry for Ankylosing Spondylitis (SIRAS), people with a diagnosis of axSpA who drove a motor vehicle completed a questionnaire that asked about nine different driving tasks they might struggle with – for example getting in or out of the motor-vehicle, crossing major roads or T-junctions, and making lane changes. We used this information to analyse these nine driving tasks to see if they could be grouped into similar types of driving challenges. We call these groupings of driving tasks ‘driving domains.’ Then we looked at other data from the questionnaire and from patients’ clinical notes to see what characteristics make it more or less likely for someone to struggle with these driving domains. Lastly we looked to see whether struggling with any of these driving domains was related to having missed any work recently or feeling less productive at work.

What did we find?

It was common for people to have some difficulty with the driving tasks we asked about – 90% of people had difficulty with at least one of the nine tasks.

When we grouped these nine tasks, we found that they fell into one of three driving domains. These represented:

  1. Challenges with changeable driving situations (e.g. driving down a crowded high street),
  2. Challenges with the physical nature of driving (e.g. sitting for a long time), and
  3. Crossing traffic.

Changeable driving situations

Physical nature of driving

Crossing traffic

This Photo is licensed under CC BY-SA

This Photo is licensed under CC BY-NC-ND

This Photo is licensed under CC BY-SA

 

People who had chronic widespread pain, knee and back pain, fatigue, high disease activity and anxiety or depression were more likely to have difficulty with these driving domains. People who struggled the most with these driving domains were more likely to have missed work in the last 7 days and were 2-3 times more likely.

Why does this matter?

As driving difficulties are common in people with axSpA and impact on their work, it is important to improve understanding and awareness of driving as a common issue that people with axSpA struggle with. This will help to direct advice and patient resources to support people to remain independent. People with musculoskeletal conditions may feel wary of bringing up driving as an issue to clinicians and it’s important that clinicians discuss driving with patients in a supportive and enabling way.

Who authored this study?

This research was conducted and co-authored by LaKrista Morton, Gary J Macfarlane, Gareth T Jones, Karen Walker-Bone, & Rosemary Hollick.

Who funded this work?

SIRAS was funded by unrestricted grants from Pfizer and AbbVie, and the secondary analysis of this data for the current paper was supported by the Versus Arthritis/MRC Centre for Musculoskeletal Health & Work.

Where can I read more?

To view the full scientific paper, click here.

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